The Care Model That Could Help Solve the Social Care Crisis, Shared Lives Plus

The Shared Lives network offers adults who need support the chance
to move in with or regularly visit approved carers around the UK.
Sharing family and community life is at the heart of its care model,
creating real and organic relationships between people and families –
some of which have lasted over 40 years. CEO Alex Fox talks about
what makes Shared Lives unique – and its potential to help solve the
social care crisis.

 

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How does the Shared Lives model work and why is it unique?

There are 150 independent Shared Lives schemes all around the UK, and these recruit people to become Shared Lives carers.

The average age for a Shared Lives carer is 55, and they’re often
people who have worked in another form of care and support before.
They’re also often coming into Shared Lives at a point when, perhaps,
their kids have grown up, and they’ve got a couple of spare rooms and
space and flexibility to help. They could be looking for a lifestyle
change, and to use their caring skills more on their terms.

Potential carers are put through a rigorous approval process and then
matched with an adult who needs support. These could be people who are
disabled or older people, and the care is paid for in the same way as
other social care. The level of support will depend on what someone is
entitled to through their social care assessment.

Once the match is found, carers share family and community life with
the person. About half of the 14,000 people who use Shared Lives move in
with their chosen carer and live as part of the family. The other half
visit the household regularly for short breaks or day support.

For example, Lynn is a full-time carer for her dad, Harold, who is living with dementia.
She was being offered breaks from caring, which involved him staying
overnight in a care home. But he was finding that disruptive and she was
spending her time away being anxious about him.

Harold was matched with a Shared Lives carer called Karen, and he now
goes to her house for overnight breaks. They go for walks and watch old
movies together -but they get on, and that is the main thing.

Both of them decided that was a good match. They got to meet each
other first, and it feels like a family visit for Harold. Lynn knows
he’s somewhere familiar and enjoying himself, so she can relax and get a
break – and that’s the essence of how the model works.

“None of us dream of living in a service or institution – we
want to live somewhere we’ve chosen, that feels like home, with people
we’ve chosen to be with.”
 
     
       
       
   

       
   
       

How important is the relationship between the Shared Lives carer and the person they are supporting?

Shared Lives is a formal, regulated care model; carers are trained
and paid, and all of the schemes are inspected by the Care Quality
Commission (CQC), but it feels personal to the people involved. It works
best for people looking for an extended support relationship with the
same person – I meet people who have lived together in Shared Lives
households for 40 years, or who’ve been providing the same person with
short breaks for 15 years.

If people find people they click with, they start to treat them as
one of the family, and the person being supported doesn’t feel that
they’re staying in a service. They’re just staying in somebody’s family
home where they belong and know that people have chosen to spend time
with them.

It isn’t a clock on, clock off relationship. Shared Lives carers will
also involve their own wider family and friends, and they may all even
go on holiday together, for instance.

With an epidemic of loneliness in the UK and millions of older people
saying that the TV is their main source of company, we think that
models which bring people together in a natural relationship can make a
huge difference.

Can you only get real person-centred care with small-scale support?

The support is small-scale, but some of the larger Shared Lives
schemes look after about 400 people in an area. Collectively, Shared
Lives supports 14,000 people around the UK – and the service has grown
organically. None of us dream of living in a service or institution – we
want to live somewhere we’ve chosen, with people we’ve chosen to be
with.

“We need people to think about social care in the same way
they think about the NHS, which is as a huge achievement and something
that should be celebrated.”
       
       
       
   

       
   
       

What sort of outcomes do you see with people using Shared Lives?

People say that they make friends. Older people and their families really like the consistency. Family carers
say they have confidence in the people that they’re linked with, and
that they like the fact that they’ve chosen somebody, and it’s a
consistent person.

A family carer said to me recently that it’s like extending your own
family – so the idea of two families working together really appeals.
PSSRU at Kent University has done research and evaluation of Shared Lives and its role for people and also found those kinds of positive results.

There are still, obviously, elements of formality in that Shared
Lives is a regulated service with safeguarding procedures. But I think
in care people are aiming for a relationship that doesn’t feel
hierarchical.

People often say they feel that their family have benefited from
having these new people coming into their lives and thinking, perhaps
differently, about older people or people’s support needs.

One Shared Lives carer who supports three older people with short
breaks each week said that one of them had made a real connection with
his teenage son and that had brought him out of his shell.

Is it easier for families feel positive about care with this kind of model?

Initially, families can be sceptical about the model because they
haven’t heard of it – even though it’s in almost every area now. I think
people often haven’t quite got their heads around it as it’s unusual
and doesn’t fit what people expect from a care service.

When people talk about social care, it’s usually in relation to sick
or older people in a crisis. People are aware of home care and care
homes, but they’re not aware, necessarily, that there are other models.

Usually, families’ views of Shared Lives change as soon as they meet
the people involved. When they see their relative’s connection to the
carer, families often get really positive and can’t understand why this
kind of service isn’t more widely offered.

For updates on Shared Lives Plus, follow them on Twitter HERE.

And follow Alex Fox on Twitter HERE.

Shared Lives is also currently developing a Home from Hospital service – what role does that play?

With Home from Hospital, we are focusing on people who need slightly
longer term support when they come out of hospital such as people
recovering from a stroke.

Also, some older people might be expected to be in and out of
hospital over a period of time, so we link that person with the same
Shared Lives carer so that they always get their step down care from the
same household.

Could models such as Shared Lives be a solution to the social care crisis?

NHS England is investing
£1.75 million in developing Shared Lives as a health service with seven
clinical commissioning groups, which is significant. It’s part of their
integrated, personalised commissioning programme, which is trying to
personalise healthcare by offering people different healthcare models.

These include giving people personal health budgets and the option to
control the money that would’ve been spent on them through continuing
health care.

We’ve also had considerable backing from the Department of Health, but we are calling on the Government to do much more because we think that there’s a step change in how Shared Lives is used.

In his first speech on social care, Jeremy Hunt
talked about backing innovation, but we don’t need to necessarily
invent lots of new ideas. There are ideas out there that are working,
like Shared Lives, which have never been scaled. That tends to be our
problem in the UK – we’re actually bursting with new ideas, but we’re
not very good at bringing them to scale.

We know though that whenever we send government ministers to visit
Shared Lives, they always come back saying, “Why don’t we do more of
this?”

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What is your vision for Shared Lives over the next five years?

I think Shared Lives will be fully established as a health and social
care model and it’s a perfect fit because the system is trying
desperately to integrate health and social care and we do that very
naturally.

I think we will see some really exciting developments around new care
models, and we’ll also see the opposite happening in some areas where
things will get worse. Sooner or later, I think the government is going
to have to significantly increase the amount of money it puts into
social care for it to survive.

We have to be more ambitious than just survival though. We have to
convince people, particularly the Treasury, that we’ve got something
worth investing in.

The future of social care can’t just be a story about all the
problems; we have to convince the world that it is a good thing, not
just something that you try to avoid. We need people to think about
social care in the same way they think about the NHS, which is as a huge
achievement and something that should be celebrated.

Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

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